Congress Does Realize Problem is Not ALJs

[factfinder]

link

Try the above link.

Congress is faced with a true emergency - the DIB fund going under and they seem to have listened to those offering some constructive solutions and ignored the nincompoops blaming the ALJs. Although, the CDR on high paying judges is a bit of an exception, but not a bad idea.

Looks like they also listened to former SSA Judge Drew Swank who many dislike, but whom I always respected for his scolarship and attention to detail, if not what he did vis a vie VEs.

Pathetic that Bice wants so many cases done - she is working against the tide but if she does not realize it, she will be found out in time.

[privateatty]

2.8% or 44 out of 1570 ALJs have a "high" allowance rate and this according to the Committee is a "large number"?

Even assuming that in fact they are outliers and pay many more cases than they should, this is hardly a shocking number.

[hamster]

Great letter to Acting Commissioner Colvin. Except as to the suggestion to increase the number of video hearings, these suggestions are spot-on. Now the question is, will she listen?

[chessparent]

Good stuff in here. Funny, but the only "backlog" mentioned was the CDR backlog. And not a word about underachieving slackers who only adjudicate 498 claims a year. I'll go read it again in case I missed something the first time around. Or could it be that low productivity is just not a real Congressional concern?

[moopigsdad]

I think the House Committee letter left out Item # 12, which would probably state something along the lines of: "Despite all of our other suggestions in this letter to improve the efficiency of SSA, we have come to the conclusion that the best way to improve SSA and prevent the SSDIB and SSI Trust Funds from running out of money is to do away with SSA all together. This move will ensure tha system, which in our opinion is a welfare-like system, will no longer be a drain upon the pocketbooks of hard working tax paying Americans. We, as Americans, would be able to return to the (pre-SSA) days where all Americans will be freely allowed to save for their own retirements; learn to rely upon family, friends and their churches should an unforeseen disability arise preventing one's further employment; and lastly allow all people to freely invest their entire life's savings into the stock market without limitation or safety net for their golden years. This move will ensure the free market system will thrive; people will become more self-reliant without need to rely upon the Federal Government to protect them in old age or in times of disability; and most importantly allow us, Members of Congress, to carry out our signed Grover Norquist pledges to never raise taxes."

[Deleted]

Great Post! Good Stuff! I agree that it’s nice that there is no ‘fire the ALJ’s’ suggestion.
My favorites:
5. SSA should revise the “treating source” rule to allow ALJ’s to consider all relevant medical opinions.
6. Hearings should be properly noticed and the evidentiary record should be closed a suitable amount of time prior to the hearing.
8. SSA needs to modernize its medical-vocational guidelines

Good suggestions. I can’t think of a time since I joined the Agency that the ALJ’s haven’t been saying this in one form or another. Particularly the grid rules.

Least favorites:

1. SSA needs to conduct timely CDR’s and revise Medical Improvement Standard.

Ug. One, SSA doesn’t have the staff and/or the resources to conduct CDR’s at this level. I just don’t think it’s possible. Please see: diminishing returns. Two, I am concerned about the idea couched in a few of these suggestions that the “big problem” is fraud. I don’t think that’s the big problem. And focusing limited resources in this direction seems, to me, like a faulty plan. Third, I have a large issue with the endless “churning” of SSA cases. The claimant’s come back, over and over, and over, re-opening old claims, over and over, and the AC sends them back for another bite at the apple, over and over. No wonder we have a backlog. More CDR’s and more attention to medical improvement means more people booted from the system, more appeals of that decision, and more re-applications and people try to get back into the system. Churn, churn, churn.

9. SSA should expand the Appeals Council’s use of “own motion” review.

More Ug. My least favorite. This suggestion makes clear that if your ALJ numbers are not in line, (Quick! Am I a ‘red flag’ ALJ?!?) more of your cases are reviewed and sent back by the AC. Please see: Churn, churn, churn. (Dear ALJ X, you are paying too many of your cases on a percentage basis. We are sending all these back for you to hear again. Please stop complaining that you hear cases in one of the poorest states in the Union, with the highest rate of high school dropout, illiteracy, diabetes, obesity, heart disease, etc.)

“Between 2005 and 2009, nearly one-third of ALJ’s were reversing at least 80 percent of DDS denials.”

There are lies, damn lies, and statistics. I think this is deceptive and misleading. Every ALJ knows that the local DDS bounces almost everyone. Twice. I assume that many claimants simply fall out of the system somewhere in that process. To actually get to a hearing requires a certain amount of perseverance and determination. That’s a lot of hoops to jump through. By the time they get to us, the claimant is either really disabled or really really wants the benefit. Either way, the fact that a lot of easy denials get weeded out before they get to us is not acknowledged. Also, the real truth, the big problem: I see a lot of over 50, high school dropouts, with lumbar DDD, obesity, diabetes, heart disease, COPD, and work experience in the oil/gas industry or agriculture (i.e. very heavy), semi-literate with no transferable skills. It should not be a surprise that my pay rate is 65%.

[christina]

Robg, great post. Wish we worked together. Your comments on 9 in particular are so right on the money.

[maquereau]

Just read an article: According to the journal "Brain," 60 percent of people over age 40 have some degree of cervical disc degeneration. That's just the cervical spine. Considering the lumbar and thoracic, virtually all Americans over the age of 40 have DDD. Guess what, about half of America is also obese - and that usually leads to or is comorbid with DM. These are just the facts of life. I could pull people age 40 and up off the street at random and find these conditions in most of them. Just having these conditions does not equal disability. If that were the case, we may as well declare national bankruptcy now.

Depression: we all seem to have it. It takes very little to get a psychologist to sign off saying that you are depressed. If you tell the shrink that you regularly think about killing yourself, he'll sign a statement saying that you can't work. It's really not that difficult - especially if you know the RIGHT psychologists or doctors.

Some people are more easily impressed and some are just, by nature, quite credulous.

Right now we have a higher percentage of the population receiving disability benefits than at any time in our history. Even though pay rates have come down in recent years, the total number of people on the rolls is higher than ever, and we have had an increasing number of filers. This somehow happened in spite of the fact that the physical demands of most jobs have greatly lessened over time. It's weird.

Well over half the people I see are in front of me due to lifestyle choices. People drink, drug, eat, smoke, and "unsafe sex" themselves into disability. I pay these people. We all pay these people. About 5% of the people with severe psychological issues I see HAVE NOT also had a serious drug problem. Yeah, the meth and coke, and weed, and heroin, and krokidil all take their toll - and the user continues to have significant residual effects even after he has stopped using. These people get paid because they have done permanent damage to their brain and possibly other organs. Their choice - but our duty to pay.

What is the FIRST RULE OF GOVERNMENT? What you subsidize you get more of.

The era of personal responsibility ended long ago. I think the pols like it like that.

[valkyrie]

Hah! Congress is telling another organization that it need to do a better job! You would have though that we could have bought a better Congress. At least the Supreme Court will let us spend more money on them now, since since money doesn't corrupt politics. Our government is going to fold well before any trust fund.

[moopigsdad]

Apr 10, 2014 11:36:20 GMT -5 maquereau said:

Just read an article: According to the journal "Brain," 60 percent of people over age 40 have some degree of cervical disc degeneration. That's just the cervical spine. Considering the lumbar and thoracic, virtually all Americans over the age of 40 have DDD. Guess what, about half of America is also obese - and that usually leads to or is comorbid with DM. These are just the facts of life. I could pull people age 40 and up off the street at random and find these conditions in most of them. Just having these conditions does not equal disability. If that were the case, we may as well declare national bankruptcy now.

Depression: we all seem to have it. It takes very little to get a psychologist to sign off saying that you are depressed. If you tell the shrink that you regularly think about killing yourself, he'll sign a statement saying that you can't work. It's really not that difficult - especially if you know the RIGHT psychologists or doctors.

Some people are more easily impressed and some are just, by nature, quite credulous.

Right now we have a higher percentage of the population receiving disability benefits than at any time in our history. Even though pay rates have come down in recent years, the total number of people on the rolls is higher than ever, and we have had an increasing number of filers. This somehow happened in spite of the fact that the physical demands of most jobs have greatly lessened over time. It's weird.

Well over half the people I see are in front of me due to lifestyle choices. People drink, drug, eat, smoke, and "unsafe sex" themselves into disability. I pay these people. We all pay these people. About 5% of the people with severe psychological issues I see HAVE NOT also had a serious drug problem. Yeah, the meth and coke, and weed, and heroin, and krokidil all take their toll - and the user continues to have significant residual effects even after he has stopped using. These people get paid because they have done permanent damage to their brain and possibly other organs. Their choice - but our duty to pay.

What is the FIRST RULE OF GOVERNMENT? What you subsidize you get more of.

The era of personal responsibility ended long ago. I think the pols like it like that.

So maquereau, should we as a society just say too bad for those people who (because of their own doing) are now mentally (and sometimes physically) incapable of working? You did it to yourself, now suffer. Taking it to the extreme the person who drives an automobile decides personally to drive the automobile on a highway and is involved in a life changing accident affecting him physically and mentally for the rest of his life. Do we say to him, you did it to yourself by driving? Too bad for you. Yes, there is indeed a need for people to take personal responsibility for their actions, but there is also a need to be cognizant of those less fortunate than ourselves who now are in a bad situation. I don't say give benefits because you feel sorry for someone, but if that person meets the rules and regulations, he or she is entitled to benefits.

Also, you bring up the issue of more people being on disability rolls than ever in history. Perhaps, one of the reasons for that is the issue of "baby boomers" turning older in larger numbers than in the past. The medium age of the American population has increased as well as the percentage of people in the total population over the age of 45 has increased greatly over the last few years. Hence, there is a logical reason why (with the SSA Regulations and Rules as written) that more people are now on the disability rolls in greater numbers than ever in the past.

[hopefalj]

"What is the FIRST RULE OF GOVERNMENT?"

Don't talk about government? Or am I getting that confused with another organization's first rule?

[Ace Midnight]

Fight Club, government - same thing.

[sealaw90]

mpd, I don't think maq was taking this to the extreme example, just an observation.
"People drink, drug, eat, smoke, and "unsafe sex" themselves into disability. I pay these people. We all pay these people... people get paid because they have done permanent damage to their brain and possibly other organs. Their choice - but our duty to pay."

This doesn't sound too harsh to me, but perhaps I am reading this too simplistically. I didn't take this as an indictment of all people, just one ALJ's observation from the bench. It must get frustrating to see all these people destroy their bodies. But it happens, and the rules are written to pay them becasue it costs money to live - even if the living is a modest, broken life.
It is our duty to pay and take care of those who failed to take care of themselves - that's the law, but it doesn't make it any easier to see disabilities that are directly related to recreational drug use and other lack of self-control/lack of responsible behavoirs - not a moral issue, just a sad state of living.

[moopigsdad]

Apr 10, 2014 12:22:33 GMT -5 sealaw90 said:

mpd, I don't think maq was taking this to the extreme example, just an observation.
"People drink, drug, eat, smoke, and "unsafe sex" themselves into disability. I pay these people. We all pay these people... people get paid because they have done permanent damage to their brain and possibly other organs. Their choice - but our duty to pay."

This doesn't sound too harsh to me, but perhaps I am reading this too simplistically. I didn't take this as an indictment of all people, just one ALJ's observation from the bench. It must get frustrating to see all these people destroy their bodies. But it happens, and the rules are written to pay them becasue it costs money to live - even if the living is a modest, broken life.
It is our duty to pay and take care of those who failed to take care of themselves - that's the law, but it doesn't make it any easier to see disabilities that are directly related to recreational drug use and other lack of self-control/lack of responsible behavoirs - not a moral issue, just a sad state of living.

Sealaw I don't disagree with your premise regarding bad behaviors. I do think maquereau's response was a retort to robg's post about paying 65% of high school dropouts with DDD, obesity, etc. in his state. I could have misread it too, but it seemed to me that the language used responded to robg's post. If I am wrong I apologize for my mischaracterization.

[sealaw90]

yeah, it could've been a retort to robg, so maybe I misread!. I suggest we stay mum and let maq tell us!

[funkyodar]

You wanna know one of the biggest reasons people get paid at the hearing level that were denied by dds?

The backlog. As people wait for their hearing they get older. They move from a grid category of not disabled to a grid disabled with the change of age categories even if the alj finds the exact same rfc that denied them at the state level.

Wanna fix that congress? Decrease the wait for hearings. Hire more aljs. I know where you can find some excellent candidates.

[bowser]

My personal view - while I am all for expanded welfare/rehabilitation/treatment/education programs for the least able members of our society, I think there are considerable negative repercussions from continually expanding the categorization of people as "disabled."

Heck, most individuals up to well over age 60 are physically and mentally capable of performing the most undemanding jobs in existence. Of course, those jobs don't exist where our claimants live, and/or no employer in their right mind is going to hire them when they have countless younger annd less impaired candidates. Unfortunately, I feel SS disability has been accepted by many folk - from claimants to policy-makers, as our country's de facto general welfare program.

With a list that long, I would have hoped they would have addressed the impact of law firms profiting from churning volumes of cases and seeing what sticks with the least effort on their part, rather than properly working up the most deserving cases. Sure, it was suggested in terms of closing the record and submitting all evidence, but my personal opinion is that claimants' representatives are not held as accountable as they ought to be.

[maquereau]

MPG and Sealaw: in fact, my post was a response to robg's observation that he pays so many cases because he sees a higher percentage of people with disabling conditions relative to other ALJs. I've been in a number of different ODARs in different parts of the country. There just was not that much difference in the kinds of things that claimants allege to be disabling. Yes, my pay rate is lower, though it is far from what some might consider to be an "outlier's" pay rate. I try to do the best I can on every case and pay the ones that I think deserve it under our program criteria and deny the one's who don't deserve it - again, strictly based on program criteria. If you do this, you will not get into much trouble. I have paid many cases where, considered personally, I thought the claimant to be something of a scoundrel. I have paid a whole lot of cases where the claimant basically did himself in with the practices I mentioned in my previous post. That doesn't mean I think the person is deserving in any moral sense, nor does it mean that I don't think we have to start changing the way we apply disability criteria. These were just my observations from having performed this work for awhile.

[moopigsdad]

Maq, I can appreciate your viewpoint on the issue. No two people will see claimants exactly alike, especially on issues of credibility. Hopefully, the issues of what the medical records show are pretty close between the ALJs. Hence, there could be a different decision made on the exact same claimant's case by two different ALJs. No matter how much SSA talks about standardizing decision-making at all levels across the county, as long as decisions continue to be made by human beings (ALJs) there will always be some differences of opinion and differences in decisions.

[Gram Pop]

Apr 10, 2014 12:07:27 GMT -5 moopigsdad said:

Apr 10, 2014 11:36:20 GMT -5 maquereau said:

Just read an article: According to the journal "Brain," 60 percent of people over age 40 have some degree of cervical disc degeneration. That's just the cervical spine. Considering the lumbar and thoracic, virtually all Americans over the age of 40 have DDD. Guess what, about half of America is also obese - and that usually leads to or is comorbid with DM. These are just the facts of life. I could pull people age 40 and up off the street at random and find these conditions in most of them. Just having these conditions does not equal disability. If that were the case, we may as well declare national bankruptcy now.

Depression: we all seem to have it. It takes very little to get a psychologist to sign off saying that you are depressed. If you tell the shrink that you regularly think about killing yourself, he'll sign a statement saying that you can't work. It's really not that difficult - especially if you know the RIGHT psychologists or doctors.

Some people are more easily impressed and some are just, by nature, quite credulous.

Right now we have a higher percentage of the population receiving disability benefits than at any time in our history. Even though pay rates have come down in recent years, the total number of people on the rolls is higher than ever, and we have had an increasing number of filers. This somehow happened in spite of the fact that the physical demands of most jobs have greatly lessened over time. It's weird.

Well over half the people I see are in front of me due to lifestyle choices. People drink, drug, eat, smoke, and "unsafe sex" themselves into disability. I pay these people. We all pay these people. About 5% of the people with severe psychological issues I see HAVE NOT also had a serious drug problem. Yeah, the meth and coke, and weed, and heroin, and krokidil all take their toll - and the user continues to have significant residual effects even after he has stopped using. These people get paid because they have done permanent damage to their brain and possibly other organs. Their choice - but our duty to pay.

What is the FIRST RULE OF GOVERNMENT? What you subsidize you get more of.

The era of personal responsibility ended long ago. I think the pols like it like that.

So maquereau, should we as a society just say too bad for those people who (because of their own doing) are now mentally (and sometimes physically) incapable of working? You did it to yourself, now suffer. Taking it to the extreme the person who drives an automobile decides personally to drive the automobile on a highway and is involved in a life changing accident affecting him physically and mentally for the rest of his life. Do we say to him, you did it to yourself by driving? Too bad for you. Yes, there is indeed a need for people to take personal responsibility for their actions, but there is also a need to be cognizant of those less fortunate than ourselves who now are in a bad situation. I don't say give benefits because you feel sorry for someone, but if that person meets the rules and regulations, he or she is entitled to benefits.

Also, you bring up the issue of more people being on disability rolls than ever in history. Perhaps, one of the reasons for that is the issue of "baby boomers" turning older in larger numbers than in the past. The medium age of the American population has increased as well as the percentage of people in the total population over the age of 45 has increased greatly over the last few years. Hence, there is a logical reason why (with the SSA Regulations and Rules as written) that more people are now on the disability rolls in greater numbers than ever in the past.

MPD, you have a valid point. Some of the additions to the disability rolls are due to changes in the Regs. When you see a 40 something Mom on SSI with three of her five children also receiving SSI for their "disability" it is pretty easy to see that there is room for improvement. My experience in this area goes back nearly 40 years and I remember clearly when SSI first began. Claims for disabled children were relatively rare and usually involved very serious medical conditions. It generally takes some time, but eventually the people for whom these types of programs are designed learn how to "game" the system and there is a never-ending supply of medical providers and legal reps who will assist claimants in their efforts to qualify. This has certainly played a part in the ever-growing rolls of the disabled. I am not a sociologist nor do I want to be. I would be happy as a simple ALJ, toeing the line; following the rules. I would leave the more serious issues to those with the qualifications to address them.